The invention relates generally to the field of hair transplantation, and more particularly to the placement of grafts of skin having at least one hair into incisions within the scalp. In this regard, the invention provides improved forceps and methods which facilitate the placement of such grafts into the incisions.
Modern hair transplantation procedures typically involve transplanting very small sections of scalp tissue (commonly referred to as grafts) containing between about 1 to 6 hairs. During a single surgical session, the number of transplanted grafts may range from about 300 to about 3,000 or more. In the procedure, the grafts must be moved quickly to ensure survival of the living hairs and to complete the surgery in a timely way.
The grafts are placed in small openings in the portion of the scalp receiving the hairs. To minimize damage to the receiving scalp, the openings for the grafts are made as small as possible, i.e. usually comprising linear incisions measuring about 1 to about 1.5 mm in length or small round holes measuring between about 1 and about 1.5 mm in diameter. To insert the grafts into such small openings, fine tipped stainless steel forceps are used. The forceps grasp the graft and deliberately insert the graft into the opening. The insertion process is challenging since both the graft and the tips of the forceps must be introduced into the opening. Preferably, the forceps introduce the graft at least 4 to 5 mm deep into the scalp. With the graft inserted, the forceps are withdrawn, leaving the graft in place.
During the insertion process, certain risks of damaging the living hairs are present. For example, the forceps, by pressure or by mechanical grinding together of the steel forceps tips, can crush, partially cut or even completely sever hairs in the grafts. Damage to hairs in this manner usually results in poor or no survival of the transplanted hairs. Typical prior art designs of forceps for small graft insertion are generally about 4 to 6 inches in overall length and are commonly referred to as fine tipped forceps. The tips of such forceps have a contact area that measures approximately 0.025 inches in width and about 0.040 inch to about 0.60 inch in length. The contact area used to grasp the grafts is therefore a minimum of about 0.001 square inch. The finger pressure typically applied to the forceps to grasp the graft is approximately 1.0 oz. Such a force applied to a contact area of 0.001 square inch produces a pressure exceeding 62 lb./sq. inch.
Small grafts of approximately 1 to 2 hairs are generally grasped at a lateral edge by the connective tissue along side the individual hairs. If a portion of the hair itself is accidentally grasped, the large force is sufficient to permanently destroy the hair. Larger grafts of about 3 to 6 hairs are grasped with the forceps tips straddling the grafts. There is generally enough resiliency in the larger grafts to tolerate the pressure during insertion of the grafts. However, many grafts may not be sized properly to allow easy insertion. When a graft resists entering the scalp opening, additional pressure may unconsciously or inadvertently be applied to the graft to help quickly place the graft into the incision. In such cases, the finger pressure may be increased to 5.0 oz. or more, creating pressures on the graft tissue of about 312 lbs./sq. inch or more. Such pressures can crush the entire population of hairs within the graft. Many of the hairs are thus in jeopardy of survival with this greater pressure. The pressure is also great enough to allow the forceps to shift from their parallel alignment. As the forceps tips shift there can be a grinding or shearing effect on the graft. This shearing effect can be easily observed as the hairs are severed.
Hence, it would be desirable to provide improved forceps and methods which would limit the pressure applied to hair transplant grafts and to help prevent the grinding together or shearing effect of the forceps tips. In this manner, large numbers of grafts may be rapidly transplanted into small incisions in the scalp without supplying excessive pressure which could otherwise damage or ruin the hairs within the graft.